title: Common community-acquired infections and subsequent risk of multiple myeloma: a population-based study.
abstract: The role of bacteria and viruses as aetiological agents in the pathogenesis of cancer has been well established for several sites, including a number of haematological malignancies. Less clear is the impact of such exposures on the subsequent development of multiple myeloma (MM). Using the population-based U.S. Surveillance Epidemiology and End Results-Medicare dataset, 15,318 elderly MM and 200,000 controls were identified to investigate the impact of 14 common community-acquired infections and risk of MM. Odds ratios (ORs) and associated 95% confidence intervals (CIs) were adjusted for sex, age and calendar year of selection. The 13-month period prior to diagnosis/selection was excluded. Risk of MM was increased by 5-39% following Medicare claims for eight of the investigated infections. Positive associations were observed for several infections including bronchitis (adjusted OR 1.14, 95% CI 1.09-1.18), sinusitis (OR 1.15, 95% CI 1.10-1.20) pneumonia (OR 1.27, 95% CI 1.21-1.33), herpes zoster (OR 1.39, 95% CI 1.29-1.49) and cystitis (OR 1.09, 95% CI 1.05-1.14). Each of these infections remained significantly elevated following the exclusion of more than 6 years of claims data. Exposure to infectious antigens may therefore play a role in the development of MM. Alternatively, the observed associations may be a manifestation of an underlying immune disturbance present several years prior to MM diagnosis and thereby part of the natural history of disease progression.
authors.affiliation: Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
authors.forename: Charlene M
authors.initials: CM
authors.lastname: McShane
authors.forename: Liam J
authors.initials: LJ
authors.lastname: Murray
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
authors.forename: Lesley A
authors.initials: LA
authors.lastname: Anderson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D016017:Odds Ratio; D012306:Risk; D018426:SEER Program; D014481:United States / Q000453:epidemiology
keywords: herpes zoster; infections; multiple myeloma; respiratory tract infections